Pandemic impacting rural nurses’ mental health

The words of Niccolò Machiavelli 500 years ago still ring true today.

The Severe Acute Respiratory Syndrome (SARS) outbreak in 2003 had a severe impact on health-care providers’ mental health, and the same is expected from the current COVID-19 pandemic.

University of Saskatchewan (USask) College of Nursing Assistant Professor and Director of the Nurse Practitioner program Dr. Mary Ellen Labrecque (PhD) and PhD candidate Michelle Pavloff (Research Chair, Rural Health, Saskatchewan Polytechnic) have been conducting research to evaluate the impact of COVID-19 on the mental health of nurses practicing in rural and remote communities in the province.

“Rural and remote health-care settings typically have limited resources and staffing shortages,” said Labrecque. “Adding a global pandemic to the already strained system is of particular concern, as it may lead to a decrease in the ability of nurses to care for their patients and increased burnout.”

Between April and August 2020, Labrecque and Pavloff and their research team facilitated virtual discussion groups with registered nurses practicing throughout rural and remote Saskatchewan. Labrecque said they hoped to achieve two main goals through the group discussions.

“The purpose of these sessions was to not only learn about the impact the pandemic is having on the nurses’ mental health, but to also determine what they felt they needed in order to increase their knowledge in regards to dealing with COVID-19,” said Labrecque.

The concerns arising from the group discussions were what Labrecque and Pavloff anticipated. Participants were overwhelmed with their workload, as co-workers had to take time off to self-isolate. Nurses were also worried about providing care when they lacked properly fitting personal protective equipment (PPE), and there was an overwhelming consensus that the new policies being created were not developed with rural areas in mind.

“Nurses are burning out, particularly in rural and remote centres,” said Pavloff. “Although they realize everyone is learning as they go during a pandemic, the participating nurses agreed the overall lack of consistency has added to their anxiety. Some felt as though they received too much information and they didn’t know where to start and others were frustrated with the lack of information and training they were receiving.” 

According to the researchers, the most important piece of information gathered from the discussion groups was that participants felt overwhelmed and worried about COVID-19 infection prevention and control. When the research team discovered this, they knew there had to be a way to help—a way to put their research into action. The result? Virtually facilitated simulation.   

“We use simulation in our nursing programs to create scenarios where students can safely practice a procedure before performing it on a patient at the bedside, so why wouldn’t we also use simulation to train these rural and remote nurses in the areas they identified as lacking training in?” said Pavloff.

Using an online platform, Labrecque and her research team connected nurses and their emergency department teams in rural and remote facilities with virtual simulation facilitators. The simulation scenarios gave the team practice caring for a patient who tested positive for COVID-19. The simulation also gave nurses the opportunity to practice exploring their role in care and assisting physicians with intubating a patient, the proper use of COVID-required PPE, and proper infection control protocol. The simulation event was supported by facilitators from across Western Canada and the United States. 

The virtual simulated training was well received by everyone. One participant was quoted saying, “The free opportunity for the virtual learning was AMAZING!!!! Thank you so much for that. It is greatly appreciated.”

Labrecque and Pavloff anticipate the information the team gathered from the group discussions will help nurses beyond Saskatchewan.

“The overall goal of this project is to increase the sharing of COVID-19 information among nurses across Canada and provide frontline nurses with more knowledge about available resources and strategies available to help them,” Labrecque said.

The project was funded by a Research Connections: COVID-19 Rapid Response Grant, through the Saskatchewan Health Research Foundation.